| NPI | 1144641226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: PA DC010824) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: PA AJ010606) |
| Enumeration Date | 2013-12-17 |
| Last Update Date | 2013-12-17 |